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Mortality after percutaneous coronary revascularization: Prior cardiovascular risk factor control and improved

Awsan Noman1, Karthik Balasubramaniam2, M Hafez A Alhous1

  • 1Cardiology Department, Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 29, 2016
PubMed

Insights

Patients with diabetes mellitus requiring insulin after percutaneous coronary intervention (PCI) face higher mortality. However, those managed with diet or oral medications show similar outcomes to non-diabetic individuals post-PCI.

Area of Science:

  • Cardiology
  • Diabetology
  • Interventional Cardiology

Background:

  • Diabetes mellitus (DM) is a significant risk factor for coronary artery disease (CAD).
  • The impact of contemporary glycemic and risk factor management on outcomes after percutaneous coronary intervention (PCI) in DM patients remains unclear.

Purpose of the Study:

  • To evaluate mortality rates in patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI).
  • To compare outcomes based on insulin requirement and the urgency of the PCI procedure (elective, urgent, emergency).

Main Methods:

  • Retrospective analysis of prospectively collected data from 9,224 patients undergoing PCI between 2008 and 2011.
  • Comparison of mortality rates between non-diabetic, non-insulin treated diabetic (NITDM), and insulin-treated diabetic (ITDM) patients.

Main Results:

  • ITDM patients exhibited significantly higher 30-day and longer-term mortality rates compared to non-DM patients (adjusted OR for 30-day mortality: 2.82; adjusted HR for longer-term mortality: 1.88).
  • NITDM patients did not show a statistically significant increase in mortality compared to non-DM patients.
  • Similar mortality trends were observed across all PCI settings.

Conclusions:

  • Higher mortality is observed exclusively in insulin-treated diabetic patients post-PCI, even with modern risk factor management.
  • Diabetic patients managed with diet or oral hypoglycemic agents achieve outcomes comparable to the non-diabetic population after PCI.
  • This highlights the importance of treatment strategy in managing diabetic patients undergoing PCI.
Abstract

Keywords:
diabetes mellitusmortalitypercutaneous coronary intervention

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